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Methods A 2009 follow-up of a 2005 study achieved 71% retention (n= 723). The 2009 sample included AIDS-orphaned (n= 236), other-orphaned (n= 231), and non-orphaned (n= 220) adolescents, whose primary caregivers were AIDS sick (n= 109), other sick (n= 147), and healthy (n= 220). Abuse and transactional sex were measured using widely used and validated self-report measures.

Results AIDS orphanhood and parental AIDS sickness predicted emotional and physical abuse and transactional sexual exploitation. Orphanhood or parental sickness by non-AIDS causes, and having healthy caregivers, did not predict any abuse outcomes. Adolescents “dually” affected by AIDS orphanhood and sickness showed a 3-fold likelihood of severe emotional and physical abuse and, amongst girls, a 6-fold likelihood of transactional sexual exploitation, compared with those in healthy families. Heightened risk of …